Biomechanical comparison of the bone-screw-fastener to conventional cortical buttress screw in a simulated ex vivo model of equine midbody proximal sesamoid bone fracture repair.
Thomas J O'Brien, James W Johnson, Christopher E Kawcak, Ben C Gadomski, Ryan S Carpenter, Brad B Nelson
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引用次数: 0
Abstract
Objective: To compare implant failure and gap displacement characteristics of simulated medial mid-body proximal sesamoid bone (PSB) fractures repaired with bone-screw-fasteners (BSF) or cortical screws (CS) in single or double screw configurations.
Study design: Ex vivo experimental study.
Sample population: A total of 14 paired equine cadaver forelimbs.
Methods: Medial mid-body PSB osteotomies were created in each forelimb. Surgical repair was performed using either: (1) single 3.5 mm BSF (BSFsingle), (2) single 4.5 mm CS (CSsingle), (3) two 3.5 mm BSFs (BSFdouble), or (4) two 3.5 mm cortical screws (CSdouble) (n = 7 repairs/group). Biomechanical properties and failure characteristics were evaluated through a single cycle to failure. Comparisons between groups were made using Wilcoxon-matched pairs or Mann-Whitney tests. Statistical significance was p < .05.
Results: The BSFdouble group (2081 ± 181 N) had significantly higher yield than BSFsingle (1458 ± 92 N, p = .01) and CSsingle (1532 ± 86 N, p = .02) groups. The CSdouble group (2101 ± 126 N) had significantly higher yield than BSFsingle (p = .001) and CSsingle (p = .003) groups. Biomechanical properties were not different between BSFsingle and CSsingle groups, or between BSFdouble and CSdouble groups. Gap measurements at construct failure were significantly higher abaxially than axially in all groups (all p < .05).
Conclusion: No differences were detected between the single BSF and 4.5 mm CS for repair of medial mid-body PSB fractures. Surgical repair using two screws has biomechanical advantage to single screw repair, regardless of screw type ex vivo.
Clinical significance: The BSF is not different to CS for repair of PSB fractures. Counteracting abaxial forces in surgical repair of mid-body PSB fractures warrants further investigation.
目的：比较骨-螺钉-固定物（BSF）与皮质螺钉（CS）在单螺钉和双螺钉配置下修复模拟中体近端籽骨（PSB）骨折的种植失败和间隙位移特征。研究设计：体外实验研究。样本种群：共14对马尸体前肢。方法：采用前肢内侧中体PSB截骨术。手术修复使用：(1)单个3.5 mm BSF (BSFsingle),(2)单个4.5 mm CS (CSsingle),(3)两个3.5 mm BSF (BSFdouble)，或(4)两个3.5 mm皮质螺钉（CSdouble） （n = 7个修复/组）。通过单周期失效评估生物力学特性和失效特征。组间比较采用wilcoxon配对或Mann-Whitney检验。结果：BSFdouble组（2081±181 N）的产量显著高于BSFsingle组（1458±92 N）， p =。01)和CSsingle(1532±86 N, p =。02)组。CSdouble组（2101±126 N）产量显著高于BSFsingle组（p = .001）和CSsingle组（p = .003）。BSFsingle组与CSsingle组、BSFdouble组与CSdouble组生物力学性能无显著差异。所有组在构建失败时的间隙测量值均显著高于轴向间隙测量值（均p）。结论：单个BSF与4.5 mm CS在修复内侧中体PSB骨折方面无差异。手术修复采用双螺钉比单螺钉具有生物力学优势，无论螺钉类型如何。临床意义：BSF与CS修复PSB骨折无明显差异。在手术修复中体PSB骨折时抵消背向力的作用值得进一步研究。
期刊介绍：
Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations.
It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
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